Analyzing renal involvement in 100 cases of hematological malignancy

Background: Hematological malignancies are the most common nonrenal neoplasms affecting the kidneys. The incidence and type of renal involvement in these malignancies are variable and differ according to malignancy. Objective: To study the prevalence of renal involvement in hematological malignancies and to study the clinical profile of patients in various malignancies. Materials and Methods: A total of 100 consecutive patients of hematological malignancies (leukemia, lymphoma, and multiple myeloma) were prospectively studied for renal involvement and clinical profile. Results: There were 72 men and 28 women with mean age of 46.85 ± 19.23 years. Among them, 43% patients had leukemia, 33% patients had lymphoma, and 24% patients had multiple myeloma. Renal failure was present in 37% of the total patients and one-third patients were having azotemic symptoms at presentation. Mean blood urea and serum creatinine levels were 73.75 ± 77.49 and 2.42 ± 3.22 mg/dl, respectively. Mean glomerular filtration rate (GFR) was 71.29 ± 54.92 ml/min and 17% patients had GFR < 15 ml/min; 62.5% patients of multiple myeloma had renal failure. Four patients had acute urate nephropathy (three patients had acute leukemia and one patient had multiple myeloma). Of the total, 18% patients had hypercalcemia and 41.7% patients had myeloma. Hyperuricemia was observed in 55.5% patients. Tumor lysis syndrome was seen in three patients and all these patients were having multiple myeloma. Male sex, multiple myeloma, and hyperuricemia were significant factors contributing to renal failure (p < 0.05). Conclusion: All patients with hematological malignancies should be evaluated for renal dysfunction and all preventive measures should be used in these patients, especially when initiated on chemotherapy.